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Author: Erden, MuratScopus Q: Q2

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    Citation - WoS: 7
    Citation - Scopus: 7
    Vitrified-Warmed Blastocyst Transfer Timing Related To Lh Surge in True Natural Cycle and Its Impact on Ongoing Pregnancy Rates
    (Elsevier Sci Ltd, 2022) Erden, Murat; Polat, Mehtap; Mumusoglu, Sezcan; Ozbek, Irem Yarali; Dere, Gonca Ozten; Sokmensuer, Lale Karakoc; Yarali, Hakan
    Research question: Does the timing of warmed blastocyst transfer in true natural cycle (tNC) differ according to six different commonly used definitions of LH surge, and do differences in timing have any impact on ongoing pregnancy rate (OPR)?Design: Prospective monitoring, including repeated blood sampling and ultrasound analyses of 115 warmed blastocyst transfer cycles performed using tNC between January 2017 and October 2021.Results: The reference timing of follicular collapse +5 days would be equivalent to LH surge +6 days in only 5.2- 41.2% of the cycles employing the six different definitions of the LH surge. In contrast, the reference timing was equivalent to LH surge +7 days in the majority of cycles (46.1-69.5%) and less commonly to LH surge +8 days (1.8- 38.3%) and +9 days (0-10.4%). For each definition of the LH surge, the OPR were comparable among the different warmed blastocyst transfer timings related to the LH surge (LH surge +6/+7/+8/+9 days). When logistic regression analysis was performed to evaluate the independent effect of variation of warmed blastocyst transfer timing (LH surge +6/+7/+8/+9 days) on OPR and taking LH surge +6 days as the reference, change in timing was not an independent predictor of OPR for any of the definitions of the LH surge.Conclusions: Employing a policy of performing warmed blastocyst transfer on follicular collapse +5 days and using six different definitions of the LH surge, vitrified-warmed embryo transfer timing is indeed equivalent to LH surge +7/+8 and even +9 days in a significant proportion of tNC with comparable reproductive outcomes.
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    Citation - WoS: 5
    Citation - Scopus: 5
    Comparison of the Efficacy of Subcutaneous Versus Vaginal Progesterone Using a Rescue Protocol in Vitrified Blastocyst Transfer Cycles
    (Elsevier Sci Ltd, 2023) Yarali, Hakan; Mumusoglu, Sezcan; Polat, Mehtap; Erden, Murat; Ozbek, Irem Yarali; Esteves, Sandro C.; Humaidan, Peter
    Research question: Does administration of subcutaneous (s.c.) progesterone support ongoing pregnancy rates (OPR) similar to vaginal progesterone using a rescue protocol in hormone replacement therapy frozen embryo transfer cycles?Design: Retrospective cohort study. Two sequential cohorts -vaginal progesterone gel (December 2019-October 2021; n=474) and s.c. progesterone (November 2021-November 2022; n=249)-were compared. Following oestrogen priming, s.c. progesterone 25 mg twice daily (b.d.) or vaginal progesterone gel 90 mg b.d. was administered. Serum progesterone was measured 1 day prior to warmed blastocyst transfer (i.e. day 5 of progesterone administration). In patients with serum progesterone concentrations <8.75 ng/ml, additional s.c. progesterone (rescue protocol; 25 mg) was provided.Results: In the vaginal progesterone gel group, 15.8% of patients had serum progesterone <8.75 ng/ml and received the rescue protocol, whereas no patients in the s.c. progesterone group received the rescue protocol. OPR, along with positive pregnancy and clinical pregnancy rates, were comparable between the s.c. progesterone group without the rescue protocol and the vaginal progesterone gel group with the rescue protocol. After the rescue protocol, the route of progesterone administration was not a significant predictor of ongoing pregnancy. The impact of different serum progesterone concentrations on reproductive outcomes was evaluated by percentile (<10(th), 10-49(th), 50-90(th) and >90(th) percentiles), taking the >90(th) percentile as the reference subgroup. In both the vaginal progesterone gel group and the s.c. progesterone group, all serum progesterone percentile subgroups had similar OPR.Conclusions: Subcutaneous progesterone 25 mg b.d. secures serum progesterone >8.75 ng/ml, whereas additional exogenous progesterone (rescue protocol) was needed in 15.8% of patients who received vaginal progesterone. The s.c. and vaginal progesterone routes, with the rescue protocol if needed, yield comparable OPR.